Nursing Elites

1. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?

• A. Providing activities for the child on restricted activity
• B. Feeding the child a protein-restricted diet
• C. Carefully handling edematous extremities
• D. Observing the child for evidence of hypotension

Correct answer: A

Rationale: The most appropriate nursing intervention for a 7-year-old child with acute glomerulonephritis experiencing gross hematuria and bed rest is to provide activities for the child on restricted activity. It is important to keep the child engaged in light activities to prevent boredom and maintain some level of physical and mental well-being. Feeding a protein-restricted diet (Choice B) is not typically indicated in this scenario unless ordered by a healthcare provider to manage kidney function. Carefully handling edematous extremities (Choice C) is important in conditions like nephrotic syndrome but is not directly related to providing appropriate care for a child with acute glomerulonephritis. Observing the child for evidence of hypotension (Choice D) is important in general nursing care but is not the most immediate or specific intervention needed for a child with acute glomerulonephritis experiencing gross hematuria and bed rest.

2. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

• A. 440
• B. 400
• C. 410
• D. 450

Correct answer: A

Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.

3. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

• A. Position the newborn in a semi-Fowler position.
• B. Allow the newborn to stay in the nursery for observation.
• C. Offer the newborn pacifier for comfort.
• D. Wrap the newborn in blankets and place in an incubator.

Correct answer: A

Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.

4. Which law provides for infants and toddlers aged 0-2 who are in need of comprehensive early intervention services?

• A. IDEA- Part B
• B. IDEA- Part A
• C. IFSP
• D. IDEA- Part C

Correct answer: D

Rationale: The correct answer is D, IDEA Part C. IDEA Part C specifically focuses on providing early intervention services to infants and toddlers with disabilities. This law ensures that children aged 0-2 receive the necessary support and services to aid in their development and address any disabilities or developmental delays early on. Choices A, B, and C are incorrect. IDEA Part B pertains to services for school-aged children with disabilities, IDEA Part A does not exist in the context of the Individuals with Disabilities Education Act (IDEA), and IFSP stands for Individualized Family Service Plan, which is a document outlining services for children from birth to age 3 who are experiencing developmental delays or disabilities, but it is not a law in itself.

5. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?

• A. Clay-colored stools and dark urine
• B. History of early passage of meconium in the newborn period
• C. History of chronic, progressive constipation and failure to gain weight
• D. Continual bouts of foul-smelling diarrhea

Correct answer: C

Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.

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